405British Journal of Occupational Therapy September 2009 72(9) Practice analysis Practice context

There is growing interest among health care professionals in clinical applications of mindfulness meditation, such as dialectical behaviour therapy (DBT) (Linehan 1993), mindfulness-based cognitive therapy (Segal et al 2002) and mindfulness-based stress reduction (MBSR). MBSR is a specific application of mindfulness training for people with chronic conditions, such as cancer, cardiovascular disease and chronic pain (Salmon et al 2004, Ott et al 2006). It was developed in l979 by Jon Kabat-Zinn and colleagues at the University of Massachusetts Medical Center in the United States, and is now the most frequently cited method of mindfulness training (Baer 2003). Described by its founders as a form of participatory medicine, a primary tenet of MBSR is that human beings have ‘deep and life-long resources for learning, growing, healing and personal transformation’ (Kabat-Zinn 2000, p239). MBSR is designed to mobilise these inherent capacities through a partnership model of medicine, which engages participants in active learning and lifestyle change for improved health (Kabat-Zinn 2003). Traditionally, MBSR adopts an educational rather than a therapeutic orientation. Classes include people with mixed diagnoses or conditions in order to emphasise commonalities and strengths rather than promote identification with diagnoses or dysfunction (Kabat-Zinn 2000). Drawing on principles of behavioural medicine and Buddhist meditative traditions, MBSR provides systematic training in mindfulness meditation, together with group discussion and education on topics such as stress management, weekly homework assignments and the applications of mindfulness training in daily life (Kabat-Zinn 2005). Although some studies suggest that mindfulness-based interventions are clinically efficacious, more research is needed to understand the factors associated with the delivery of the interventions as well as the outcomes (Kabat-Zinn 2003). A meta-analysis of health benefits by Grossman et al (2004) found that MBSR might help a broad range of individuals to cope with distress and disability in everyday life. Baer’s Mindfulness-based stress reduction for people with chronic condition